Blue Cross® Physician Choice PPO

Starting Jan. 1, 2024, the Blue Cross Physician Choice PPO plan is closed for all individuals and groups. This content is intended for reference only for dates of service prior to 2024.

Blue Cross® Physician Choice PPO uses Organized Systems of Care, or OSCs. These are communities of doctors and hospitals within our PPO network that provide coordinated, high quality care and lower costs.

Product summary

A handy summary for providers, including a list of participating level 1 organized systems of care, is available in this Blue Cross Physician Choice PPO provider flier (PDF).

Frequently asked questions

This FAQ document has answers to questions about Blue Cross Physician Choice PPO, including information on cost share, claims payments, referrals and more.

User guide

The Blue Cross Physician Choice PPO e-referral User Guide (PDF) is a step-by-step guide through the e-referral system, especially for Blue Cross Physician Choice PPO providers.

How do the cost share levels work?

Level 1 cost share (lowest costs)

Member must first choose a primary care doctor in a Level 1 OSC.

  • Member uses doctors and hospitals in that Level 1 OSC.
  • Or, member chooses providers in the PPO network outside that Level 1 OSC, with a referral from the primary care doctor.
Level 2 cost share (higher costs)

Member doesn't choose a primary care doctor.

Or, member chooses a primary care doctor not in a Level 1 OSC.

Or, member chooses a primary care doctor in a Level 1 OSC, but chooses providers outside that OSC without a referral.
Out-of-network cost share (highest costs)

Member chooses doctors and hospitals outside our PPO network.

Referrals for Level 1 cost share do not apply outside the PPO network.

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